Soft Drink Consumption: Innocent Indulgence intake, which contributes to the prevalence of obesity.20,21 dentin and resin composite fillings leading to cavities. Traditional colas (Coca-Cola® and PepsiCo®) are the When poor oral hygiene and bruxism are present, tooth or Dangerous Drinking Habit? most frequently drunk sodas; each 360ml can contribute loss risk considerably increases. 43 kcal/100ml (or 110 calories (cal) in 360ml, up to Louis Z.G. Touyz - BDS MSc MDent 310 cal in 960ml cola).21-24 Newer pop manufacturers, Ad libitum consumption of soft drinks carries Department of Periodontics, Faculty of Dentistry, McGill University, Montreal, Canada | [email protected] who use organic contents with cranberry or maple syrup consequences. It is noteworthy that experimental 22 evidence in animals, backed up by epidemiological data, Kelvin I. Afrashtehfar - DDS MSc as sweeteners, claim it is tastier and more natural. strongly suggests esophagitis is on the increase from Department of Re-constructive Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland | [email protected] Bec Soda Inc. (Montreal, QC), a newcomer to the pop- beverage scene in North America, is manufactured quaffing modern over-sized ingestion of pop-sodas. With regular consumption of acidic sugar sweetened pop with maple syrup in dissolved CO2 to give it sparkle. Maple syrup is mainly carbohydrate and water and has drinks as a major source of dietary calories, damage to ABSTRACT high caloric value at 252 kcal per 100ml syrup, with both soft and hard tissues through calcium deprivation 23 occurs over a period of time. The effects of nascent Many carcinogenic substances are known. Recently, soft drinks (pop, soda, lolly water) have been implicated in constituent monosaccharides like fructose and glucose. release of dissolved CO will induce cellular genetic research as causing esophageal and other pre-cancerous changes. Many carcinogenic substances are known, In a few years Bec Soda, as a start-up company, 2 changes leading to early epithelial dysplasia. This is a among which carbon dioxide in gassy-drinks is becoming more and more into contention. However, gassy sugar produces over 100000 350ml bottles annually and 22 serious effect as under continual oncogenic stimulation, sweetened drinks are generated on an industrial scale and its increasing production, promotion and consumption cannot meet the consumers demand. From 1970 to early dysplasia predisposes to developing epithelial progresses unbound. This article warns about excess consumption of soft drinks as a cofactor in many conditions, such 1996, consumption of soft drinks increased from 22.2 changes which become irreversible and precede invasive as osteoporosis, dental abfractions and diabetes, but particularly for dysplastic esophagitis, which often precedes gallons to 56 gallons per person per year. It is estimated forms of carcinoma. neoplastic transformation. Moderation of imbibing soft drinks is advised. that 95% of Americans drink soda, and 27% of all beverages consumed are sodas. CO2 gas dissolves in KEYWORDS water to form carbonic acid, which enhances flavor, CONCLUDING REMARKS intensifies sweetness of fermentable acid-producing Carbonated Beverages, Carcinogens, Neoplastic Cell Transformation, Diabetes Mellitus, Esophagitis, Osteoporosis. The effects of uncontrolled consumption of soft drinks carbohydrate molecules and delivers the tingle on the on soft tissue has focused mainly on weight gain tongue when consumed in sugary acidulated drinks.25 and tooth decay, however, early warnings about the possible carcinogenic effects may be absurd to ignore. BACKGROUND DISCUSSION Moderation to not more than one pop-soda a week or Although some causes of cancer are known, the exact dysplasia. Dysplasia may be mild, moderate or severe, Pop consumption is a multimillion dollar industry, replacement of sugary-sweetened-pop with plain water, causes of most cancers remain obscure. For example, the latter being definitively diagnostic and close to globally valued at $55 billion dollar per year. Even unsweetened tea, coffee, milk, soups, vegetable or fruit human papilloma viruses (HPVs) are strongly associated mutations of early carcinogenesis.12,13 though non-nutritive sweeteners and low calorie drinks beverages, is strongly advised. causatively with most head and neck cancers, as well are also available and consumed, vast quantities of as cervical and genitourinary neoplastic changes.1-3 Experimentally in rats, esophageal dysplasia has been sugar sweetened pop-sodas are regularly consumed as REFERENCES Other oncogenic viruses are well known in research induced by drinking pop.14 In humans, the erythroplasia a cheap source of calories, for hunger satiation and a 1. Touyz LZG. Human papilloma pirus (HPV)-A Biological and Clinical Appraisal: 2013. Science Postprint 1(1): e00001. biomodels.4 Neoplastic-inducing substances like of Queyrat on mucous membranes (i.e. Bowen substitute for nutritious foods. There are ten teaspoons 2. Touyz LZ. Politics, health and mesothelioma: when it 3 Disease),15 and Barret esophagitis16,17 are two forms of asbestos and the cyclic-carbon substance di-methyl- (about 29 Grams) of carbohydrates in 12 ounces of pop comes to cancer, none is one too many. Curr Oncol. 5,6 benzanthracene (DMBA) are also known carcinogens. dysplasia found in the penis and esophagus, respectively. (a 360ml can), and because one can of pop gives 110 2012;19(5):e374-5. It is noteworthy that the prevalence of the latter seems to cal, 3 to 4 cans per day adds between 430 to 440 cal 3. Touyz LZ Tobacco and health: with or without pictures, nothing Neoplastic change is usually a multistage reaction be increasing.18,19 daily extra to a diet. Consequently, this is considered a redeems smoking. Curr Oncol. 2012;19(4):e229-31. sometimes preceded by, and often detectable with major contributor to childhood obesity. 22-25 4. Dittmer DP, Damania B, Sin SH. Animal models of clinical changes. This change is often influenced by The causes of dysplasia are varied, and range from tumorigenic herpesviruses-an update. Curr Opin Virol. 2015;14:145-50. predisposing factors. For example, AIDS-sufferers are actinic and X-ray radiation to chemical genetic Previous reports have warned against excess mutagenesis to viruses and changes in immunity.4 5. Wang WC, Chen CY, Hsu HK, Lin LM, Chen YK. more prone to developing oncological lesions because consumption of gassy pop and increased prevalence of Chemopreventive effect of Toona sinensis leaf extract on 7-9 Among the many known conditioners for carcinogenic 16,17 HIV infection reduces natural immunity. Also DNA Barrett esophagitis. There are also other unwanted 7,12-dimethylbenz[a]anthracene-induced hamster buccal alterations induced by tobacco smoke and excess use change indicated by animal research is the excessive side effects like pancreatic cancer formation,26,27 pouch squamous cell carcinogenesis. Arch Oral Biol. of ethanol alone, or agonistically in combination with exposure to carbon dioxide (CO2) gas release from soft and decreased osteogenesis which leads to bone 2016;70:130-42. 17 tobacco use, are acknowledged as conditioning habits, drinks (pop, soda, lolly water). fractures among young healthy physically active 6. Chaudhry AP, Reynolds DH, Gorlin RJ, Vickers RA. which facilitate a cellular oncogenic transformation.10,11 women.28 Moreover, increased dietary consumption Experimental carcinogenesis in submandibular glands of hamsters. J Dent Res. 1961;40:426-32. The objective of this appraisal is to highlight the of carbohydrate and diet low-calorie pop is also 7. Goedert JJ, Coté TR, Virgo P, Scoppa SM, Kingma DW, The transformation from a healthy state to frank implications of the global increase in consumption of soft significantly associated with a higher risk of having drinks, and a call for its moderation. Gail MH, Jaffe ES, Biggar RJ. Spectrum of AIDS-associated carcinoma is reflected clinically by early noticeable a stroke.29 An increased intake of sugar-sweetened malignant disorders. Lancet. 1998;351(9119):1833-9. changes, often visible to the naked eye, but often only beverages may increase the likelihood of developing 8. Frisch M, Biggar RJ, Engels EA, Goedert JJ; AIDS-Cancer possible to be confirmed histologically.12 Macroscopically, RECENT INSIGHTS diabetes mellitus, and all the sequelae from this, Match Registry Study Group. Association of cancer with a lump is first noted with the appearance of a rolled Post World War II, with the introduction of pop in cans like pancreatic cancer, cardiovascular pathologies, AIDS-related immunosuppression in adults. JAMA. edge, an ulcer, bleeding or painless swelling as a instead of glass, and marketing larger plastic containers neuropathies and ophthalmic changes.28-30 2001;285(13):1736-45. lump or papule. Additionally, changes of epithelium up to two liters, encouraged a vast increase in daily 9. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90. to fixed white patches (i.e. leukoplakia), red macules pop consumption. Although adolescents periodically Tooth decay and dental erosion are the main deleterious 10. Holt PG. Immune and inflammatory function in cigarette (i.e. erythroplakia), or combinations of the two (i.e. do consume tea, coffee, milk and fruit juices, their effects on teeth of drinking soda.31-37 For instance, the smokers. Thorax. 1987;42(4):241-9. erythro-leukoplakia) are early putative changes, which preference for sugar sweetened pop-sodas remains acids in soft drinks reduce the surface hardness of the 11. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. when biopsied will show various stages of histological a significant part of their diet and increased caloric enamel leading to erosion. Soft drinks can also affect Global cancer statistics. CA Cancer J Clin. 2011;61(2):69-90.

| 40 | Smile Dental Journal | Volume 11, Issue 4 - 2016 Smile Dental Journal | Volume 11, Issue 4 - 2016 | 41 | 12. Riffat F, Dwivedi RC, Palme C, Fish B, Jani P. A systematic 26. Mueller NT, Odegaard A, Anderson K, Yuan JM, Gross M, review of 1143 parapharyngeal space tumors reported Koh WP, Pereira MA. Soft drink and juice consumption and over 20 years. Oral Oncol. 2014;50(5):421-30. risk of pancreatic cancer: the Singapore Chinese Health Study. 13. Badreddine RJ, Prasad GA, Wang KK, et al. Prevalence and Cancer Epidemiol Biomarkers Prev. 2010;19(2):447-55. predictors of recurrent neoplasia after ablation of Barrett’s 27. Bao Y, Stolzenberg-Solomon R, Jiao L, et al. Added sugar esophagus. Gastrointest Endosc. 2010;71(4):697-703. and sugar-sweetened foods and beverages and the risk of 14. Soffritti M, Belpoggi F, Degli Esposti D, Lambertini L, pancreatic cancer in the National Institutes of Health-AARP Tibaldi E, Rigano A. First experimental demonstration Diet and Health Study. Am J Clin Nutr. 2008;88(2):431-40. of the multipotential carcinogenic effects of aspartame 28. Bernstein AM, de Koning L, Flint AJ, Rexrode KM, Willett administered in the feed to Sprague-Dawley rats. Environ WC. Soda consumption and the risk of stroke in men and Health Perspect. 2006;114(3):379-85. women. Am J Clin Nutr. 2012;95(5):1190-9. 15. Sanchez-Palacios C, Guitart J. Hydroxyurea-associated 29. Bao Y, Stolzenberg-Solomon R, Jiao L, et al. Added sugar squamous dysplasia. J Am Acad Dermatol. 2004;51(2):293-300. and sugar-sweetened foods and beverages and the risk of 16. Touyz LZ. Challenging obesity relating to Barrett pancreatic cancer in the National Institutes of Health-AARP esophagitis. Curr Oncol. 2010;17(3):8. Diet and Health Study. Am J Clin Nutr. 2008;88(2):431-40. 17. Kapicioğlu S, Baki A, Reis A, Tekelioğlu Y. Cola drinks 30. Touyz LZ. Mixing drinks and concocting troubles. Curr consumption and oesophagitis. Dis Esophagus. 1999;12:306–8. Oncol. 2011;18(6):262-3. 18. Shaheen NJ, Sharma P, Overholt BF, et al. Radiofrequency 31. Heller KE, Burt BA, Eklund SA. Sugared soda consumption ablation in Barrett’s esophagus with dysplasia. N Engl J and dental caries in the United States. J Dent Res. Med. 2009;360(22):2277-88. 2001;80(10):1949-53. 19. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 32. Borjian A, Ferrari CC, Anouf A, Touyz LZ. Pop-cola acids 2003;349(23):2241-52. and tooth erosion: an in vitro, in vivo, electron-microscopic, 20. Esophageal cancer: epidemiology, pathogenesis and and clinical report. Int J Dent. 2010;2010:957842. prevention. Nat Clin Pract Gastroenterol Hepatol. 33. Ferrari CIC, Touyz LZG. Clinical implications from an in 2008;5(9):517-26. vitro and in vivo investigation of acidity, erosion and pain 21. Centers for Disease Control and Prevention (CDC). from common pop-acidulated drinks. Intl J Clin Dent. Beverage consumption among high school students 2013; 6(3):279-90. United States, 2010. MMWR Morb Mortal Wkly Rep. 34. Bernstein AM, de Koning L, Flint AJ, Rexrode KM, Willett 2011;60(23):778-80. WC. Soda consumption and the risk of stroke in men and 22. Delean P. Success sweet for organic soda. FP Montreal. 2016. women. Am J Clin Nutr. 2012;95(5):1190-9. The Montreal Gazette. Tues 21 Jun 2016. Section B; p1-2. 35. Moynihan PJ, Kelly SA. Effect on caries of restricting sugars 23. Lentner C. Geigy Scientific Tables. th8 Edition. Vol 1. intake: systematic review to inform WHO guidelines. J Dent Composition of Foods. Confectionary sugars. Maple syrup. Res. 2014;93(1):8-18. 1981. p252. Ciba-Geigy. 36. A. Lussi A, Jaeggi T, Scharer S. Prediction of the erosive 24. McDonalds Quality and Nutrition Information. A full serving potential of some beverages. Caries Res. 1995;29(5):349–54. of Nutrition Facts. McDonalds Corporation. OakBrook, Il 37. Wongkhantee S, Patanapiradej V, Maneenut C, Tantbirojn 60523.USA. Coca Cola Classic; Mar 2004. p10. D. Effect of acidic food and drinks on surface hardness of 25. Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink enamel, dentine, and tooth-coloured filling materials. J consumption on nutrition and health: a systematic review Dent. 2006;34(3):214–20. and meta-analysis. Am J Public Health. 2007;97(4):667-75.

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